An easy-to-build, low-budget point-of-care ultrasound simulator: from Linux to a web-based solution

Abstract

Background: Hands-on training in point-of-care ultrasound (POC-US) should ideally comprise bedside teaching, as well as simulated clinical scenarios. High-fidelity phantoms and portable ultrasound simulation systems are commercially available, however, at considerable costs. This limits their suitability for medical schools. A Linux-based software for Emergency Department Ultrasound Simulation (edus2TM) was developed by Kulyk and Olszynski in 2011. Its feasibility for POC-US education has been well-documented, and shows good acceptance. An important limitation to an even more widespread use of edus2, however, may be due to the need for a virtual machine for WINDOWS^® systems. Our aim was to adapt the original software toward an HTML-based solution, thus making it affordable and applicable in any simulation setting.

Methods: We created an HTML browser-based ultrasound simulation application, which reads the input of different sensors, triggering an ultrasound video to be displayed on a respective device. RFID tags, NFC tags, and QR Codes™ have been integrated into training phantoms or were attached to standardized patients. The RFID antenna was hidden in a mock ultrasound probe. The application is independent from the respective device.

Results: Our application was used successfully with different trigger/scanner combinations and mounted readily into simulated training scenarios. The application runs independently from operating systems or electronic devices.

Conclusion: This low-cost, browser-based ultrasound simulator is easy-to-build, very adaptive, and independent from operating systems. It has the potential to facilitate POC-US training throughout the world, especially in resource-limited areas.

Keywords: Point-of-care systems; Simulation training; Ultrasonography.

Fig. 1

Different devices such as laptop computers, desktop computers/PCs, smartphones as well as tablets can be used to display video files, that is, ultrasound loops, respectively. These are triggered by tags, the content of which is read as a keystroke. RFID radio-frequency identification, USB universal serial bus, QR quick response, OTG on the go, NFC near-field communication. VID. FILE video of ultrasound loop stored as a separate file

Fig. 2

Three-dimensional printed mock ultrasound probe with RFID antenna. a Raw material as printed. b The partly disassembled RFID antenna, which originally has USB-stick format. c How the antenna is built into the housing. d The complete probe with USB wire

Fig. 3

Left panel shows the simulator using a mobile phone for the display of a specific ultrasound loop video, Right panel shows a commercially available handheld point-of-care ultrasound device (VSCAN DUAL, courtesy General Electric). Please note the three different profile switches, tag P1, P2, and P3 which allow for different findings to be displayed with the same tag 1, 2, 3, or 4, respectively